Objectives: Coronary heart disease is frequent in the working-age population. Traditional outcomes, such as mortality and
hospital readmission, are useful for evaluating prognosis. Fit-for-work is an emerging outcome with clinical as well as socioeconomic
significance. We describe the possible benefit of a cardiac rehabilitation (CR) program for return to work (RTW)
after acute coronary syndrome (ACS). Material and Methods: We evaluated 204 patients with recent ACS. They were
divided into 4 groups on the basis of their occupational work load: very light (VL), light (L), moderate (M), and heavy (H).
Work-related outcomes were assessed with the Work Performance Scale (WPS) of the Functional Status Questionnaire
and as “days missed from work” (DMW) in the previous 4 weeks. The variables considered for outcomes were percent
ejection fraction, functional capacity expressed in metabolic equivalents (METs), and participation or non-participation in
the CR program (CR+ and CR–). Results: One hundred thirty (66%) patients took part in the CR program. Total WPS
scores for CR+ and CR– subgroups were VL group: 18±4 vs. 14±4 (p < 0.001), L group: 18±3 vs. 14±3 (p < 0.0001),
M group: 19±3 vs. 16±3 (p < 0.003), and H group: 20±4 vs. 17±3 (p < 0.006). Fewer DMW were reported by the CR+
group. Conclusions: Non-participation in CR was a consistent cause of poorer work-related outcomes. Our findings indicate
that CR and occupational counseling play a very important role in worker recovery and subsequent reintegration in
the workplace, in particular among clerical workers.